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HomeMy WebLinkAbout113664 JORDAN'S TREE MOVING & MAINTENANCE INC - INSURANCE CERTIFICATE (7)OP ID: SLS IYc�RO DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/23/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Phone: 970-223-1804 NAME: Front Range Insurance Group PHONE FAX 1100 Haxton Drive Suite 100 Fax: A/c No Ext : A/C No): Fort Collins, CO 80525 E-MAIL ADDRESS: David A. Wooldridge LUTCFAAI PRODUCER JORDA-2 rno—M . e. INSURER(SI AFFORDING COVERAGE NAIC A _ INSURED Jordan's Tree INSURERA: Secure Insurance Companies 22543 Moving & Maintenance, Inc INSURER B: Pinnacol Assurance 41190 1025 Smithfield Drive Fort Collins, CO 80524 INSURERC: INSURER D : INSURER E : INSURER F : r'n\/FRArFC rFRTIFIrATF NIIMRFR• REVISION NUMBER' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR OF INSURANCE ADDTYPE I L POLICY NUMBER MM DD/YY YY MM DD/YYYY LIMITS A A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR X Prof Liab X CP003250287-3 CP003260287-3 12/19l2016 12/19/2016 12/19/2017 12/19/2017 EACH OCCURRENCE $ 1,000,00 DAMAGE TO HEN ED PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL BADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. JrCT POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Prof Liab $ 1,000,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS X A3200288 12/19/2016 12/19/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ 5,00 X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEYIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4040726 03/01/2017 03/01/2018 X I WC STATU- OTH- T CRYLIMIT ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYE $ 1,000,00 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,00 A Equipment Floater 34UUNSR3887 12/19/2016 12/19/2017 Leased 250,00 Ded 50 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Fort Collins, its officers, agents and employees are named as additional insured with regards to general and auto Liability. rc0T1r1r'AT0 unl n=o RANrFI I ATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Puchasing Dept. PO BOX 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE V lUt$U-ZUUtIAI.uKLIL,UKI'L)KAI IL)N. All rlgnis reserve0. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD